Under normal conditions, the space behind the eardrum is filled with air, which ensures the uninterrupted transmission of sound waves and, consequently, normal hearing. However, in some cases, this space fills with fluid, which can be either thin or thick. This condition is scientifically known as serous otitis and in the vast majority of cases, it affects children.
The young patient does not feel pain, but their hearing is significantly affected, potentially reduced by up to 35 dB. The issue is that most children are unable to perceive and communicate their problem, so it is up to the parents to recognize that their child may have hearing loss. Signs that may reveal this include a child who does not respond when spoken to and seems distracted or absorbed in what they are doing, as well as excessively turning up the volume on the TV. School performance is often poor, and in cases where fluid has been present since infancy, speech development may be delayed and pronunciation of words significantly affected.
The initial treatment for serous otitis is usually conservative, including special exercises, nasal irrigation, and monitoring. If this does not yield results, a tympanic membrane puncture is performed to remove the fluid, and in most cases, to prevent recurrence, a ventilation tube is placed in the eardrum. The procedure is done with sedation or general anesthesia and usually lasts 5 to 10 minutes. The restoration of normal hearing is immediate. If there is also hypertrophy of the adenoids (commonly known as “adenoids”), they are removed during the same procedure, as they have been found to contribute to fluid accumulation behind the eardrum.